Rehabilitation at the Time of Pandemic: Patient Journey Recommendations

Abstract

PurposeThe World Health Organization (WHO) declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) a pandemic in March 2020, causing almost 3.5 million coronavirus disease (COVID-19) related deaths worldwide. The COVID-19 pandemic has imposed a significant burden on healthcare systems, economies, and social systems in many countries around the world. The access and delivery of rehabilitation care were severely disrupted, and patients have faced several challenges during the COVID-19 outbreak. These challenges include addressing new functional impairments faced by survivors of COVID-19 and infection prevention to avoid the virus spread to healthcare workers and other patients not infected with COVID-19. In this scoping review, we aim to develop rehabilitation recommendations during the COVID-19 pandemic across the continuum of rehabilitation care.Materials and MethodsEstablished frameworks were used to guide the scoping review methodology. Medline, Embase, Pubmed, CINAHL databases from inception to August 1, 2020, and prominent rehabilitation organizations’ websites were searched.Study SelectionWe included articles and reports if they were focused on rehabilitation recommendations for COVID-19 survivors or the general population at the time of the COVID-19 pandemic.Data ExtractionTwo of our team members used the pre-tested data extraction form to extract data from included full-text articles. The strength and the quality of the extracted recommendations were evaluated by two reviewers using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach.ResultsWe retrieved 6,468 citations, of which 2,086 were eligible after removing duplicates. We excluded 1,980 citations based on the title and the abstract. Of the screened full-text articles, we included 106 studies. We present recommendations based on the patient journey at the time of the pandemic. We assessed the evidence to be of overall fair quality and strong for the recommendations.ConclusionWe have combined the latest research results and accumulated expert opinions on rehabilitation to develop acute and post-acute rehabilitation recommendations in response to the global COVID-19 pandemic. Further updates are warranted in order to incorporate the emerging evidence into rehabilitation guidelines.

Effects of a Multicomponent Exercise Program on Improving Frailty in Post-COVID-19 Older Adults after Intensive Care Units: A Single-Group Retrospective Cohort Study

“…A previous study by Martínez–Velilla et al [ 27 ] developed in 370 older adult patients hospitalised at acute care units have found similar results with MEP on the SPPB scale and on the Barthel Index in elderly patients but without post-COVID 19 syndrome, with respect to the usual care group. In a recent Delphi Expert Consensus and in a recent scoping review, developed rehabilitation recommendations that recommend exercise as one of the therapies to be used in post-COVID-19 patients [ 15 , 28 ] are discussed.…”

Tele-Rehabilitation Interventions for Motor Symptoms in COVID-19 Patients: A Narrative Review

“…The mechanisms underlying the functional recovery of post-COVID-19 patients are not yet fully elucidated, and the individual differences in terms of ongoing symptoms makes it difficult to define standardized rehabilitation protocols. Currently, tele-rehabilitation seems to be a feasible, safe, and effective complementary tool in managing the rehabilitation needs of post-COVID patients, opening new perspectives for a tele-health care-delivery model [ 98 , 99 ], but it does not replace face-to-face interventions [ 100 ].…”